Many Very Old Individuals Have Masked Hypertension

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Masked hypertension (MHT)—which is blood pressure (BP) that appears normal when measured in doctors' offices but which is found to be elevated when measured at home—may be common in people aged 75 years and older, according to a French study.

As result, researchers concluded that these elderly individuals should be encouraged to routinely perform home BP measurements.

The study, which included 1,814 community-dwelling individuals aged 75 years and older, found that two out of five subjects who appeared to have normal blood pressure (BP) during medical consultations were actually hypertension, investigators reported in the American Journal of Hypertension (published online ahead of print).

In the study, which was conducted by Cecilia Cacciolati, MD of Université Pierre et Marie Curie in Paris, and colleagues, all the subjects had office BP and home BP measurements taken with the same device. MHT was defined as normal BP at office visits with high BP at home. MHT has previously been shown to carry a doubling of the risk of vascular events, but not been well studied in older adults.

All subjects measured their BP at home six times a day for three consecutive days within two weeks following the visit to the study center. The frequency of MHT was 16% in the overall sample and 41% in subjects with a normal office BP. Compared with normotensive subjects, those with MHT were more frequently men, older (over age 80), had a higher body mass index, and a higher office systolic BP. In addition, subjects with MHT were more frequently diabetic and on anti-hypertensive medications (64% vs. 47%).

 “The strengths of our study lie in the large sample size, the community-based setting, and the age range of our participants, variables that have been previously little-examined,” the researchers wrote. The study population's higher education level and socioeconomic level were among the study limitations, the authors noted.

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